a1 Health Protection Agency, Centre for Infections, London, UK
a2 Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
a3 School of Social and Community Medicine, University of Bristol, Bristol, UK
a4 MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK
In developed countries the majority of hepatitis C virus (HCV) infections occur in injecting drug users (IDUs) with prevalence in IDUs often high, but with wide geographical differences within countries. Estimates of local prevalence are needed for planning services for IDUs, but it is not practical to conduct HCV seroprevalence surveys in all areas. In this study survey data from IDUs attending specialist services were collected in 52/149 sites in England between 2006 and 2008. Spatially correlated random-effects models were used to estimate HCV prevalence for all sites, using auxiliary data to aid prediction. Estimates ranged from 14% to 82%, with larger cities, London and the North West having the highest HCV prevalence. The methods used generated robust estimates for each area, with a well-identified spatial pattern that improved predictions. Such models may be of use in other areas of study where surveillance data are sparse.
(Accepted August 03 2011)
(Online publication August 30 2011)